Eddy Elkassis

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

305068 Issued in AZ

Practice address

995 E Baseline Rd Apt 2116
Tempe, AZ 85283-1363

Phone

(810) 813-5550

NPI assigned

Jan 19, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, AZ, NY3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Leading Healthcare Clinic of Goodyear LLC

  • Internal Medicine Physician
  • Goodyear, AZ
  • NPI 1902448566
  Medicare reassignment NPD
• Leading Healthcare, LLC

  • Hospitalist Physician
  • Sun City, AZ
  • NPI 1356853691
  Medicare reassignment NPD
• Blue Water Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Fort Gratiot, MI
  • NPI 1477135036

  Nurse Practitioner

  Medicare reassignment NPD
• Elizabeth Lake Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Waterford, MI
  • NPI 1538585260
  Medicare reassignment NPD
• Harper Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Saint Clair Shores, MI
  • NPI 1992442560
  Medicare reassignment NPD
• Howell Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Howell, MI
  • NPI 1063124014
  Medicare reassignment NPD
• Matrix Medical of New York PC

  • Nurse Practitioner
  • New York, NY
  • NPI 1639433063
  Medicare reassignment NPD
• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  MI

  Medicare reassignment NPD
• Mound Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Warren, MI
  • NPI 1063159630
  Medicare reassignment NPD
• Oxford Urgent Care P L C

  • Specialist
  • Oxford, MI
  • NPI 1700036936
  Medicare reassignment NPD
• Romeo Plank Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Macomb, MI
  • NPI 1184385791
  Medicare reassignment NPD
• Royal Urgent Care, PLLC

  • Internal Medicine Physician
  • Royal Oak, MI
  • NPI 1952833196
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730505600000",
    "number": "1952053258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6036 JENNIFER CRES",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483243127",
            "telephone_number": "810-813-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 E BASELINE RD APT 2116",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831363",
            "telephone_number": "810-813-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKASSIS",
        "first_name": "EDDY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-19",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704369610",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "305068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Integrated Health LLC
• Elite Medical Aesthetics PLLC
• Elite Selection LLC
• Elite Selection LLC
• Jason Elkan, FNP
• Tarig Elkhalifa
• Amie S Ell, PHARMD
• Amber Ellington, N.D.
• Elliot Road Dental PLLC
• Alexandra Elliott

• Nurse Practitioner in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.